Signs Of Colic Research Articles (Page 1)

Strangulating lipoma obstruction (SLO) is the most common cause of equine small intestinal strangulation and is fatal without surgery. Currently, epidemiological information is primarily limited to signalment-related risk factors and requires further investigation. To identify horse-level risk factors for SLO and/or abdominal lipoma(s) (LP) formation in horses with acute colic that underwent surgery or post-mortem examination at participating equine clinics. Prospective, international, multicentre, epidemiological study. An epidemiological study was conducted over 27 months (January 2022-April 2024) in 8 clinics (UK n = 4, USA n = 4) to identify variables associated with altered likelihood of SLO and/or LP. Horses presenting with acute colic signs that underwent surgery or post-mortem examination were eligible. Those (i) that had SLO as the primary cause of colic, or (ii) those that had mesenteric and/or omental lipoma(ta) (LP) were compared to horses without lipomata. Signalment, adiposity, endocrine status, and lipomata deposition data were analysed using univariable and multivariable logistic regression models. Data from 392 horses was obtained (108 SLO; 190 LP). Increasing age (odds ratio [OR] 1.23) for every year increase in age 95% CI (95% CI: 1.17-1.30, p < 0.001), male sex (OR 1.78, 95% CI: 1.08-2.95, p = 0.02) and clinical indicators of Equine Metabolic Syndrome (EMS) (OR 4.77, 95% CI: 2.93-7.77, p < 0.001) were significantly associated with increased likelihood of SLO. Increasing age, clinical indicators of EMS, indicators of previous/current laminitis (hoof growth ring score), jejunal mesenteric fat score and omental fat scores were significantly associated with increased likelihood of LP. Population restricted to horses with acute colic signs admitted to collaborating clinics. Measures to prevent adiposity and EMS development appear important to reduce the likelihood of LP and SLO. Further investigation of differential adipose tissue deposition between male and female horses is warranted.

SummaryA 4‐year‐old Thoroughbred gelding was presented with a history of severe colic signs that were non‐responsive to non‐steroidal anti‐inflammatory drugs. During initial evaluation, distended small intestine was observed, together with continued colic signs and a serosanguinous abdominocentesis sample. It was therefore elected to perform an exploratory laparotomy to ascertain and resolve the source of colic. Intraoperatively, a 2 cm horizontal defect was located at the junction between the diaphragm and the left 12th rib, midway between the dorsal and ventral body walls. One metre of small intestine was entrapped within the thoracic cavity. The diaphragmatic defect was digitally extended to 6 cm to allow safe exteriorisation of the intestine. The resulting defect extended from just left of midline to the body wall; the defect was sutured closed using 4 M polyglactin 910 in a simple continuous pattern, utilising forwarder and Aberdeen self‐locking knots. Subsequently, the horse also underwent a jejunoileostomy. The horse progressed well post‐operatively, with the exception of an incisional infection. Repeat thoracic evaluation 2 weeks post‐operatively and again 6 months post‐operatively revealed no evidence of reoccurrence.

A 19-year-old Oldenburg stallion was presented multiple times over the course of several months with recurrent colic signs. At each examination, an enlargement of the scrotum was noted, which could not be further specified by palpation and ultrasonographic examination. The increase in circumference was noted both on palpation and on inspection and the size remained unchanged throughout. No special findings were noted during the general examination and the special examination of the colic patient. A few months after the first onset of symptoms, a chicken egg-sized mass was palpated on the right testicle, extending dorso-laterally in the direction of the inguinal cleft. Due to the recurring signs and the loss of sperm quality (pathospermia), the stallion was hemicastrated with subsequent histopathological and immunohistological examination of the circumferential proliferation including the testicles and epididymis.

A four-year-old nulliparous mare was presented with a history of full-term pregnancy and colic signs. On general clinical examination, the mare was dull with bilateral distension of the abdomen. Vaginal examination revealed a softened cervix with evident liquefaction of the cervical seal. The mare was induced for parturition using oxytocin at 100 IU diluted with 1000 ml of normal saline as a slow intravenous infusion. The cervix was relaxed at one hour of intervention, enabling manual delivery of a live male foal. The mare was treated with antibiotics and anti-inflammatory drugs for three days and had an uneventful recovery. Further vaginal examination revealed an appreciable involution of the cervix with normal lochia.

Colic-related obstructions can reduced intestinal mucosa function and cause dysbiosis in horses, but it is unclear how defense barrier and secretory immunoglobulin A (SIgA) secretion is disrupted. The aim of the study is to evaluate the effect of severity of colic signs and treatments on fecal SIgA and fecal lactate in horses. Sixty-two client owned hospitalised horses with colic and eight healthy horses. Prospective clinical trial. Fecal samples were taken daily for 7 days. SIgA was analyzed using ELISA, and D/L-lactate measured with a commercial kit. At Day 0, SIgA values in the colic medical and colic surgical groups were significantly higher than in the control stable group (U = 126.0, p = 0.099, Cliff's ∆ = 0.58 and U = 248.0, p = 0.005, Cliff's ∆ = 0.72, respectively). We found significant correlation between fecal SIgA and fecal lactate level in D0 (rs = 0.421, p = 0.038). This study demonstrates the feasibility of using fecal samples to identify biomarkers of colic in horses. An increase in fecal SIgA in horses with colic might suggest the presence of inflammation within the intestines and disruption of the mucosal barrier. These data highlight changes in gastrointestinal barrier and immune function and the intestinal microbiota's metabolic activity in horses with colic.

Nine-year-old Indian Thoroughbred gelding was presented to the Large Animal Medicine Out-patient Unit of Madras Veterinary College Teaching Hospital with a history of restlessness, anorexia, not voided dung and urine, patchy sweating, flank watching, pawing, frequent lying down and getting up. Clinical examination of the animal revealed severe dehydration with tachycardia and absence of borborygmi on both sides of the abdomen. Rectal examination revealed scanty dry faeces in the rectum with distended caecum. Distended intestinal loops with the absence of intestinal peristalsis were observed through ultrasound examination. Haemato- biochemical examination revealed increases creatinine, creatine kinase and lactate dehydrogenase. The animal was treated with Inj. Ringer’s lactate and Inj. Flunixin meglumine. The animal was administered with liquid paraffin, magnesium sulphate, and simethicone along with the water through nasogastric intubation. Again the animal showed colic signs. Further the animal was sedated with xylazine and continuous rate infusion of Lignocaine @ 0.05mg/kg/min and fluids were administered through jugular catheter. The animal passed urine and showed a clinical improvement on following treatment. Animal started taking regular feed and voided dung on the third day of treatment.

Summary Background Chronic gastric dilatation and delayed emptying in horses are rarely diagnosed diseases with a supposedly poor prognosis and no promising treatment options. Objectives To describe the clinical presentation of horses diagnosed with chronic gastric dilatation and delayed emptying, and evaluate the effects of oral metoclopramide on the clinical signs of included horses. Study design Retrospective observational case series. Methods Forty‐two affected horses were included. Data was collected from clinical records between January 2011 and April 2023. A survey sent to the owners evaluated presenting complaints, percentage improvement of clinical signs associated with metoclopramide treatment and observed side effects of the treatment. Results The most common presenting complaints were recurrent signs of colic (51.7%, of which 66.7% postprandially), followed by poor performance (41.4%). The mean age at initial diagnosis was 13.2 years (min: 0.5; max: 30). Horses were treated with a mean dose of 0.15 ± 0.03 mg/kg bwt p.o. q.12 h of metoclopramide (min: 0.1; max: 0.22). The mean therapy duration at the time of data collection was 31.9 months (min: 3; max: 108). Twenty‐nine owners replied to the survey: 73% of the cases showed a clinical improvement of ≥50%, 50% an improvement of ≥75%. One horse developed colic signs after the initiation of metoclopramide treatment. The treatment was not associated with a decreased size of the stomach in 33.3% of patients reevaluated at sonography ( p = 0.2). Eight horses were euthanised because of the chronic gastric dilatation. The median survival time of the euthanised horses was 22 months (min: 12; max: 108). Main limitations Retrospective character, owner‐answered survey, no control group. Conclusion The clinical improvement by oral metoclopramide treatment with only a few side effects shown by this report suggests that this could be a treatment option for horses with chronic gastric dilatation and delayed emptying.

Equine colic remains a significant health concern with complex, multifactorial aetiologies. Gastric sand impaction, while less common than large colon sand accumulation, can lead to severe complications including gastric rupture if left untreated. This report documents a case offatalgastric sand impactionin a 12-year-old Argentine Polo Pony mare from Nigeria. The mare, maintained on ground feeding with hay and commercial concentrate feed,developed progressive colic signs over three days. Despite severe clinical deterioration, including reduced appetite, abdominal discomfort, and frequent rolling, no veterinary examination was pursued. Post-mortem examination revealed a 15 cm gastric rupture with approxi-mately 8 kg of accumulated sand, accompanied by severe peritonitis and gastrointestinal inflammation.This case emphasizes the importance of proper feeding practices, regular veterinary monitoring, and prompt intervention in equine colic cases. It also demonstrates that significant sand accumulation can occur in the equine stomach, not just the large colon, potentially leading to gastric rupture. Immediate veterinary intervention for colic signs and use of elevated feeding systems to prevent fatal sand impaction are recommended.

To report a radical surgical technique for perianal melanomas involving the anal margin in standing horses. Observational retrospective study. Twenty client-owned horses presented for surgical excision of extensive (≥4 cm) perianal melanomas. Demographic data, surgical technique, intraoperative, immediate- and late-postoperative complications were reviewed. All horses (median age 15, Q1-Q3 12 to 17.3 years) were operated under standing sedation and epidural anesthesia. Median hospitalization period was 6.5 days (Q1-Q3 5 to 8.3 days). The anal margin was fully resected in 14 cases. A deep perirectal dissection was performed in 16 cases. Eight cases required additional local anesthetics. One case bled profusely during and after the procedure. One case became recumbent during the procedure, showed intense postoperative pain, and was eventually euthanized 6 weeks later because of ataxia. During hospitalization, one horse displayed colic signs and 10 others required manual evacuation of the rectum because of decreased fecal output. Complications after hospital discharge included mild colic signs (n = 4), partial wound dehiscence (n = 1) and hypergranulation of the wound (n = 2). All other cases healed without complications in 6 to 12 weeks. Median follow-up period was 11.8 months (Q1-Q3 6.3 to 27.2 months). Six horses developed new melanomas with only one in the perianal region. This technique of surgical excision of extensive perianal melanomas was efficiently performed on standing horses with minimal local recurrence. This procedure led to high client satisfaction. Early postoperative pain was commonly encountered. Owners should be warned of the potentially large surgical wound that will be created. This technique allowed for removal of large perianal melanomas with limited recurrence during the long term follow up and may improve the quality of life of affected horses.

Post-foaling colic is a common presenting complaint for equine practitioners that requires careful evaluation. Colic signs can be attributed to conditions of the gastrointestinal, reproductive and genitourinary tracts. Diagnostic workup is similar to that of most other cases of colic, with additional attention paid to the udder, vulva and vaginal vault; transabdominal ultrasound examination is often key in establishing a diagnosis. Conditions of the genitourinary and reproductive tracts include periparturient haemorrhage, which may be intra-abdominal, intrauterine, intramural, vaginal and/or into the broad ligament, uterine tear with or without intestinal evisceration, bladder rupture, septic metritis and/or retained foetal membranes, invagination of a uterine horn, uterine prolapse and bladder prolapse. Prompt diagnosis is vital as aggressive therapy is generally required for the majority of these conditions and prognosis is variable depending on the condition and severity.

SummaryUterine torsion (UT) is a common obstetrical problem in Straight Egyptian Arabian mares, causing a medical emergency for both the mare and the fetus. This case report describes, for the first time, the management of a case of UT in both directions during a single gestation period in a 5‐year‐old Straight Egyptian Arabian mare. The mare was 8 months pregnant and experienced intermittent unresponsive colic signs. Rectal examination revealed clockwise 180° UT and ultrasonography showed a viable fetus. The haematological findings were within the normal range. The mare was surgically treated immediately by standing flank laparotomy (SFL) on the right side. 4 days later, the mare was returned to the clinic with the same complaint. Rectal and ultrasonography examinations revealed counterclockwise 180° UT and a viable fetus. The animal was subjected again to SFL on the left side. After surgeries, the mare recovered well, foaled at term and gave birth to a viable filly. She was bred again and conceived. This case is documented to demonstrate the occurrence of a UT in both directions during the same gestation period in mares, as well as the efficacy of SFL in rectifying the condition and allowing both the mother and foal to survive.

SummaryBackgroundReaching a specific diagnosis in horses with chronic or recurrent abdominal pain may be challenging and elusive.ObjectivesThe aim of this study was to report indications, findings and outcomes of equine exploratory laparoscopy in a case series to support its diagnostic value and identify potential limitations.Study designRetrospective cases series.MethodsSixty‐nine client‐owned horses underwent laparoscopic exploration of the abdomen due to chronic colic symptoms. All horses were operated standing while sedated and under local anaesthesia. Diagnosis, follow‐up, surgical or medical interventions, as well as intra‐ and postoperative complications were recorded.ResultsA definitive diagnosis could be made by laparoscopy in 61 horses. However, no abnormal findings were found by laparoscopic exploration of the abdominal cavity in eight horses. Overall, the sensitivity of diagnostic laparoscopy in the standing horse in our study was 88% and its specificity was 15%. No severe intra‐ or postoperative complications occurred. Exploratory flank laparoscopy in the standing horse can be a valuable diagnostic tool for chronic abdominal pain.Main limitationsThe limitations of the present study are its retrospective nature, missing some details in the reports. In addition, no long‐term follow‐up was available for the horses which underwent surgical intervention, and whether the colic signs reoccurred after a period of time or complications occurred in the long‐term postoperative period are not known. No confirmation of the laparoscopic diagnosis was available in some horses, and a post‐mortem examination or histology of a biopsy sample would have been beneficial.ConclusionsExploratory flank laparoscopy in the standing horse can be considered in horses with chronic abdominal pain in view of the high sensitivity and low complication rate of this study.

SummaryZuclopenthixol decanoate is a dopamine antagonist licensed for human use to manage schizophrenia and paranoid psychosis. It is in the same drug class (thioxanthene) as fluphenazine decanoate, a drug whose use in horses is reported anecdotally for providing long‐acting sedation. This case study describes severe extrapyramidal signs seen in a Thoroughbred colt after zuclopenthixol decanoate administration. The colt was presented to a referral hospital for an unusual manifestation of colic signs. On admission, the colt began to show clear extrapyramidal neurological signs. The initial suspicion was of fluphenazine decanoate toxicity, which in the limited published literature is treated with intravenous formulations of diphenhydramine hydrochloride and benztropine mesylate. At the time of writing both were unavailable in the United Kingdom without an import license. The closest alternative option, oral diphenhydramine was administered alongside intravenous atropine and pergolide. Improvements in the colt's demeanour and neurological status was noted within 24 h. The colt was hospitalised for a total of 26 days and at time of discharge was clinically normal. Follow‐up communication 3 months after discharge confirmed that the colt had remained neurologically normal. Crucially, toxicology testing submitted to Cornell University was negative for common toxins, including fluphenazine decanoate. Specific secondary testing was performed after suspicion the administration of zuclopenthixol decanoate was raised, which was positive for this compound. Routine drug testing would, therefore, not identify the use of this behaviour modifying drug. Clinical data regarding the use of zuclopenthixol in animals is limited to its use in the translocation of wildlife to relieve stress and aid acclimatisation. To our knowledge, there is no available literature describing the administration of zuclopenthixol decanoate in equine patients.

To highlight the use of procainamide as a potential alternative treatment modality in cases of ventricular tachycardia that are refractory to lidocaine and magnesium sulfate. 1 adult horse weighing 380 kg. A 25-year-old Arabian gelding presented with severe colic signs. Due to persistent pain, it was elected to carry out an exploratory laparotomy. During the procedure a diagnosis of severe, unstable ventricular tachycardia was made based on the ECG findings, with an initial heart rate of 195 beats per minute and severe hypotension. Initial treatment consisted of discontinuing dobutamine and the administration of a 2 mg/kg IV lidocaine bolus followed by a continuous rate infusion at 50 μg/kg/min. Twenty grams magnesium sulfate (5 mg/kg) was administered IV in 1 L of lactated Ringer solution as a slow bolus over 30 minutes. Ventricular tachycardia persisted with poor peripheral pulses, a severely dampened arterial waveform, and a MAP of 30 to 45 mm Hg. Two milligrams/kg IV procainamide was administered over 3 minutes, 3 separate times, at 5-minute intervals. Immediately following the third dose sinus rhythm was detected on the ECG, the arterial waveform improved, and MAP increased to 85 mm Hg. Ventricular tachycardia is a rare but potentially life-threatening complication in horses undergoing general anesthesia. The potential of this arrhythmia to progress to ventricular fibrillation is of grave concern, as the option to attempt to externally defibrillate horses back to normal sinus rhythm does not exist. This case highlights procainamide as a potential option for cases of ventricular tachycardia that are refractory to more standard treatment modalities.

To determine breed, age, and sex predispositions for fecalith obstruction and to evaluate short-term survival and prognostic factors following surgical treatment of fecalith intestinal obstruction in equids. 151 equids. Medical records of equids undergoing surgery for fecalith obstruction from 2000 to 2020 were reviewed. Signalment, history, presenting clinicopathological data, surgical findings, complications, and short-term survival were recorded and compared between survivors and nonsurvivors. Signalment of the fecalith population was compared to a contemporaneous colic population. Clinical factors were assessed for association with outcome. 64 females, 53 castrated males, and 31 intact males were included. Three equids presented twice. Miniature horses, ponies, and miniature donkeys/mules represented 48% (71/148) of fecalith population and full-sized breeds represented 52% (77/148). Miniature horses and ponies were overrepresented and equids ≤ 1 year of age were overrepresented in the fecalith population compared to the colic population. One hundred thirty-nine equids (92%) survived to discharge, 6% (9/148) were euthanized intraoperatively, and 2% (3/148) were euthanized during hospitalization. Nonsurvivors showed more severe colic signs on admission, tachycardia on admission, and hyperlipemia. Equids with postoperative colic (P = .01) and complications (P = .002) were less likely to survive. Miniature horses and ponies were overrepresented compared to the colic population; however, full-sized breeds were also affected. Surgical treatment had an excellent short-term prognosis. Severe colic signs, tachycardia, hyperlipemia, postoperative colic, and surgical complications negatively affected short-term survival.

Abstract A 2‐year‐old, male reindeer ( Rangifer tarandus tarandus ) presented for further investigations and treatment of acute colic signs. On clinical investigations, an ultrasonographic abdominal exam revealed multiple hypomotile, dilated and fluid‐filled small intestinal loops. Based on clinical findings and increased signs of abdominal pain, small intestine obstruction was suspected, and an exploratory laparotomy was performed. The animal was premedicated with medetomidine (0.003 mg/kg) and butorphanol (0.05 mg/kg) intravenously. General anaesthesia was induced with ketamine (2 mg/kg intravenously) and propofol (3 mg/kg intravenously), and maintained with isoflurane in oxygen. Additional analgesia was provided with methadone (0.1 mg/kg intravenously) and ketamine (0.5 mg/kg intravenously). A jejuno‐jejunal intussusception requiring resection of approximately 6 inches (15 cm) was identified and jejuno‐jejuno anastomosis was performed. Fluid resuscitation was administered for treatment of hypotension during general anaesthesia. Recovery from anaesthesia was uneventful. Nevertheless, the deer was euthanased 5 days later due to clinical deterioration.

SummaryThis case report describes the diagnosis and surgical treatment of a 12‐year‐old Friesian stallion that presented with colic and was diagnosed with an unilateral abdominal seminoma. The diagnostic work‐up included haematology, blood chemistry, rectal examination and ultrasonography before the tentative diagnosis of a neoplastic intra‐abdominal testicle was made. The mass was removed surgically and diagnosed as a seminoma via histopathology. Regular follow‐up was performed since suspected metastasis was seen on transrectal ultrasonography and laparoscopy. Unfortunately, the patient was subjected to euthanasia 18 months post‐surgery due to clinical deterioration. Post‐mortem examination was performed and confirmed the cause of clinical deterioration was due to metastasis of the previously removed seminoma. Colic is, to the author's knowledge, rarely seen in stallions with an abdominal testicular neoplasm, in contrast to humans and dogs.

To seek appropriate veterinary attention for horses with colic, owners must recognise early signs. Direct observation of horse behaviour has several drawbacks: it is time-consuming, hard to see subtle and common behavioural signs, and is based on intuition and subjective decisions. Due to recent advances in wearables and artificial intelligence, it may be possible to develop diagnostic software that can automatically detect colic signs. To develop a software algorithm to aid in the detection of colic signs and levels of pain. In vivo experiments. Transient colic was induced in eight experimental mares with luteolytic doses of prostaglandin. Veterinarians observed the horses before and throughout the interventions and assigned pain scores which were used to separate colic episodes into none (pain score ≤5), level 1 (pain score 6-10) or level 2 (pain score ≥11). Accelerometric data and videos were collected throughout the experiments and using accelerometric data, the horse's behaviour was classified into normal and 10 pain-related behaviours and an activity index was calculated. Models were designed that utilised behaviour and activity index characteristics both detecting the presence of colic and assessing its severity. To determine the accuracy of the model, the ground truth, that is the veterinarians' observation of colic signs and assessment of pain level, was compared with the automatic detection system. The cross-validation analysis demonstrated an accuracy of 91.2% for detecting colic and an accuracy of 93.8% in differentiating between level 1 colic and level 2 colic. The model was able to accurately classify 10 pain-related behaviours and distinguish them from normal behaviour with a high accuracy. We included a limited number of horses with severe pain related behaviours in the dataset. This constraint affects the accuracy of categorising colic severity rather than limiting the algorithms' capacity to identify early colic signs. Our system for early detection of colic in horses is unique and innovative, and it can distinguish between colic of varying severity.

Evaluation of substance P as a biomarker for pain in equine colic

SummaryThis case report describes the diagnosis and treatment of noncongenital atlanto‐axial luxation in a 10‐year‐old Irish Draught mare. The mare initially presented to our referral hospital for dullness and colic signs. After resolution of the colic signs, the horse displayed increasing levels of dullness. Physical examination revealed that the horse could not flex and extend its neck freely to reach food from the ground. Radiographic and standing computed tomographic investigations revealed atlanto‐axial luxation that was subsequently successfully reduced using a surgical approach under general anaesthesia. To the author's knowledge, this is the first case report describing the successful surgical treatment of presumed traumatic atlanto‐axial luxation in an adult horse.